Tara E Wise, M.S., O.T.R./L

NPI #1851675219 in Fort Drum, New York

Provider Information

NPI Number
1851675219
Entity Type
Individual
Name
Tara E Wise, M.S., O.T.R./L
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Military Health Care Provider
Credential
M.S., O.T.R./L
Enumeration Date
Oct 4, 2011
Last Updated
Oct 4, 2011

Practice Location

Address
11050 MOUNT BELVEDERE BLVD
ZIP Code
13602-5438
Phone
(315) 772-3380

Specialties & Taxonomy Codes

Specialty
Military Health Care Provider

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